{"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":[1013924372],"tin":{"type":"npi","value":"1013924372"}}]},{"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":[1033124961],"tin":{"type":"npi","value":"1033124961"}}]},{"provider_group_id":23,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043224355],"tin":{"type":"npi","value":"1043224355"}}]},{"provider_group_id":24,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1023172921],"tin":{"type":"npi","value":"1023172921"}}]},{"provider_group_id":25,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033270699],"tin":{"type":"npi","value":"1033270699"}}]},{"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":[1053354100],"tin":{"type":"npi","value":"1053354100"}}]},{"provider_group_id":28,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043455199],"tin":{"type":"npi","value":"1043455199"}}]},{"provider_group_id":29,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043279565],"tin":{"type":"npi","value":"1043279565"}}]},{"provider_group_id":1,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1962408203],"tin":{"type":"npi","value":"1962408203"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1952476988],"tin":{"type":"npi","value":"1952476988"}}]},{"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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"],"billing_code_modifier":["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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-14","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":["KL"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":18.72,"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":"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":"2026-05-14","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"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","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":["KL","NU"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","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"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"10580","date_of_service":"2026-05-14","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":["RR"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":53.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":71.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"48060","date_of_service":"2026-05-14","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":["UE","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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"40380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":52.49,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"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":"2026-05-14","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"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","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"],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"28740","date_of_service":"2026-05-14","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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"45060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-14","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"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":167.4,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":12.27,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","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":["RR"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","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"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"A4619","name":"Face tent","description":"Face tent","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"28880","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"35004","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","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":["NU"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","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":"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":"2026-05-14","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"]}],"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"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-14","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":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"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":"2026-05-14","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"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":422.58,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[13]},{"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":["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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":6.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"A4565","name":"Slings","description":"Slings","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"28740","date_of_service":"2026-05-14","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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","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":["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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-14","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"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","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"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"35614","date_of_service":"2026-05-14","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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"35614","date_of_service":"2026-05-14","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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"28880","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","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"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","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","KE","NU","KU"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":43.83,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-14","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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","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"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","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":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"27060","date_of_service":"2026-05-14","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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":15.51,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","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"],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":161.28,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","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":["NU"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"40380","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-14","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"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-14","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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"A4619","name":"Face tent","description":"Face tent","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"27060","date_of_service":"2026-05-14","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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","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"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-14","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":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"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":"2026-05-14","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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","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"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"13780","date_of_service":"2026-05-14","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"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":5729.02,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":1585.01,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-14","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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":2.97,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-14","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":[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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","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"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"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":"2026-05-14","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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":17.57,"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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"46540","date_of_service":"2026-05-14","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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":311.87,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"27060","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"13780","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"27060","date_of_service":"2026-05-14","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":["KL"]}],"provider_references":[3]}]},{"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":"2026-05-14","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"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"33","date_of_service":"2026-05-14","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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","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":[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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"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":"2026-05-14","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"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-14","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"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"35004","date_of_service":"2026-05-14","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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"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":"2026-05-14","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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","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":["KE","RR","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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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"],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-14","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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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.","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"33","date_of_service":"2026-05-14","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":["KL"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"A4619","name":"Face tent","description":"Face tent","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":17.33,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"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":"2026-05-14","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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":40.02,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":16.87,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"33","date_of_service":"2026-05-14","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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":0.93,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":104.58,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"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":"2026-05-14","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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"27060","date_of_service":"2026-05-14","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":["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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"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":"2026-05-14","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","NU","KU"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"35614","date_of_service":"2026-05-14","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":["RR"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","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"],"billing_code_modifier":["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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":41.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-14","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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[3]},{"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":["RR","KU"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-14","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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":1428.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":5384.21,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"46540","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"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":"2026-05-14","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"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"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":"2026-05-14","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"]}],"provider_references":[27]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-14","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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"15380","date_of_service":"2026-05-14","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":["RR"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"48060","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[29]}]},{"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":"2026-05-14","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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":4891.13,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-14","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"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"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":"2026-05-14","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"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"46540","date_of_service":"2026-05-14","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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"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)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"28740","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":525.17,"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":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"40380","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"35614","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":17.19,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":49.67,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","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"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"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":"2026-05-14","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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","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"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","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"],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-14","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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","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":["KL","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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"24020","date_of_service":"2026-05-14","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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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":["NU"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-14","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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"35004","date_of_service":"2026-05-14","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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-14","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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"33","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"40380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"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":"2026-05-14","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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"35004","date_of_service":"2026-05-14","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"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"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":"2026-05-14","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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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"],"billing_code_modifier":["RR"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"35004","date_of_service":"2026-05-14","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"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":"2026-05-14","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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":51.95,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","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":"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":"2026-05-14","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"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"35614","date_of_service":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":12.08,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"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":"2026-05-14","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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"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":"2026-05-14","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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"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":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"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":"2026-05-14","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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":2310.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","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":["RR"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"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":"2026-05-14","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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"13780","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"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":"2026-05-14","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"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":"2026-05-14","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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":2.35,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-14","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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"13780","date_of_service":"2026-05-14","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"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"27060","date_of_service":"2026-05-14","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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":72.11,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"46540","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"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":"2026-05-14","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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":156.8,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-14","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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"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":"2026-05-14","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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4565","name":"Slings","description":"Slings","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","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"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"40380","date_of_service":"2026-05-14","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"]}],"provider_references":[26]}]},{"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":"2026-05-14","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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":4.82,"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":"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":"2026-05-14","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"],"billing_code_modifier":["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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","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"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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"],"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":1.9,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":17.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-14","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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":9.01,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"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":"2026-05-14","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"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"24020","date_of_service":"2026-05-14","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"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":14.78,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"13780","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"27060","date_of_service":"2026-05-14","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"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-14","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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"15380","date_of_service":"2026-05-14","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"],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":9196.15,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":105.34,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"28740","date_of_service":"2026-05-14","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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":86.75,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"45060","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"46540","date_of_service":"2026-05-14","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"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":73.88,"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":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"28740","date_of_service":"2026-05-14","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":["KL"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","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","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":"2026-05-14","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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":8.68,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"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":"2026-05-14","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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"10580","date_of_service":"2026-05-14","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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","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"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-14","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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"40380","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"13780","date_of_service":"2026-05-14","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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"35614","date_of_service":"2026-05-14","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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","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":["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":"35614","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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"],"billing_code_modifier":["KE","NU"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"13780","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"48060","date_of_service":"2026-05-14","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"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"40380","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"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":"27060","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","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":[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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"15380","date_of_service":"2026-05-14","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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":110.4,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"48060","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":444.04,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","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"],"billing_code_modifier":["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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":437.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":87.23,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["KL","NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":7.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","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","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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"33","date_of_service":"2026-05-14","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":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":715.35,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-14","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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-14","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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":290.38,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":45.0,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":119.07,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["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)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-14","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"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":38.15,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":39.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","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":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-14","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":["NU"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-14","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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","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","NU","KU"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"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":"2026-05-14","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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-14","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"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"33","date_of_service":"2026-05-14","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":["RR"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":119.02,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"28740","date_of_service":"2026-05-14","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"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-14","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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"13780","date_of_service":"2026-05-14","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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":1426.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-14","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"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"48060","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":32.97,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","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"],"billing_code_modifier":["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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":["UE","NU","KU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":59.65,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"48060","date_of_service":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"28740","date_of_service":"2026-05-14","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"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"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":"2026-05-14","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"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-14","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":["NU"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":335.27,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["UE","NU","KU"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"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":"2026-05-14","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"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":119.02,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-14","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":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"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":"2026-05-14","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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"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":"2026-05-14","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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"15380","date_of_service":"2026-05-14","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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-14","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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":106.43,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":43.94,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","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":["UE","NU"]}],"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 ","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":1.07,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"28740","date_of_service":"2026-05-14","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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","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":["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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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","date_of_service":"2026-05-14","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"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"45060","date_of_service":"2026-05-14","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"]}],"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":"15380","date_of_service":"2026-05-14","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":["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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"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":"2026-05-14","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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"21300","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":11.91,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-14","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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"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":"2026-05-14","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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-14","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":["KL"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"13780","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":45.21,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"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":"2026-05-14","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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","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":["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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"27060","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"40380","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":155.06,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":15.12,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":0.73,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"35004","date_of_service":"2026-05-14","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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","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"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"10580","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"13780","date_of_service":"2026-05-14","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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","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"],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"28740","date_of_service":"2026-05-14","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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"21300","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":452.49,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","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":["NU"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"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":"2026-05-14","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"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"45060","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":7.83,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-14","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"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"48060","date_of_service":"2026-05-14","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"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[15]}]},{"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"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":"2026-05-14","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":["KL","NU"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":1.52,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-14","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":["NU"]}],"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)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-14","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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"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":"2026-05-14","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","NU","KU"]}],"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.","cbsa":"35004","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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 ","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"21300","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"40380","date_of_service":"2026-05-14","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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"48060","date_of_service":"2026-05-14","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","NU"]}],"provider_references":[29]}]},{"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":"2026-05-14","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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"48060","date_of_service":"2026-05-14","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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["UE","NU","KU"]}],"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":["UE","NU","KU"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","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","NU"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":13.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":24.58,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","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":["RR"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"33","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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 ","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","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":["RR"]}],"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)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"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":"2026-05-14","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"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","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":["RR"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"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":"2026-05-14","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"],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"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":"2026-05-14","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"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"45060","date_of_service":"2026-05-14","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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":2.5,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":11.91,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":6407.14,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":6778.82,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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 (","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-14","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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-14","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":[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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"35614","date_of_service":"2026-05-14","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":["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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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":["NU"]}],"provider_references":[13]},{"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":["NU"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"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":"2026-05-14","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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":63.71,"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-14","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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-14","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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":10.85,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":6977.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"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":"2026-05-14","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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","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"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"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":"2026-05-14","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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":48.32,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-14","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":[13]},{"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":"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":"2026-05-14","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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"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":"2026-05-14","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":["RR","KU"]}],"provider_references":[28]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":418.54,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"21300","date_of_service":"2026-05-14","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"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"45060","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":3.02,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","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","KU"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"A4565","name":"Slings","description":"Slings","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"45060","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-14","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"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"48060","date_of_service":"2026-05-14","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"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"15380","date_of_service":"2026-05-14","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"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-14","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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"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":"2026-05-14","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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","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","KU"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"13780","date_of_service":"2026-05-14","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","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)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-14","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":[13]},{"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":49.35,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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 ","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"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":"2026-05-14","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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","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":["UE","NU","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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","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"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"15380","date_of_service":"2026-05-14","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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","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":["RR","KU"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"40380","date_of_service":"2026-05-14","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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":24.67,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":50.61,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"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":"2026-05-14","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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":41.86,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","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"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":28.53,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":25.94,"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":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":1.68,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"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":"2026-05-14","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":["KL","NU"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":355.52,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":2299.16,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"28880","date_of_service":"2026-05-14","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":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-14","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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":12.12,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"21300","date_of_service":"2026-05-14","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"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":1085.53,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":243.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"28880","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":3.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":2476.12,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","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"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":293.57,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","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"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"35004","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","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","NU","KU"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-14","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":[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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"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":"2026-05-14","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"10580","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-14","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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"48060","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","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":["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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["RR"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"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":"2026-05-14","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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"A4619","name":"Face tent","description":"Face tent","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","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"],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":6.39,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"35004","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":49.2,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":["KE","RR","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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"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":"2026-05-14","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","NU","KU"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":133.74,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-14","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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"24020","date_of_service":"2026-05-14","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"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":6331.99,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"10580","date_of_service":"2026-05-14","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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","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","KU"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"27060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-14","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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":47.17,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"35614","date_of_service":"2026-05-14","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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":1.5,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-14","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"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"46540","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":0.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"21300","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":5399.08,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"24020","date_of_service":"2026-05-14","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"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-14","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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","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":["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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"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":"2026-05-14","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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","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":["RR"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"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":"2026-05-14","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"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":27.78,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"13780","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":19.09,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","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"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":4914.5,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":677.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-14","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"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-14","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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":285.22,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":385.14,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":97.85,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":29.18,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"28880","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"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":"2026-05-14","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"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"28740","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":231.02,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"35004","date_of_service":"2026-05-14","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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"10580","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":61.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"46540","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"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":"2026-05-14","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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","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"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"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":"2026-05-14","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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","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"]}],"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"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","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"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-14","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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["KE","RR","KU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":30.72,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":28.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":48.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"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":"2026-05-14","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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"33","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":29.08,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"15380","date_of_service":"2026-05-14","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","KU"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":65.28,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":1045.71,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"48060","date_of_service":"2026-05-14","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":["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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":1600.27,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-14","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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-14","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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-14","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":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":409.8,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":71.93,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":63.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"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":"2026-05-14","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"]}],"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":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","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"],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-14","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"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","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":["KL","NU"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-14","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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-14","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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35614","date_of_service":"2026-05-14","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","NU"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"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":"2026-05-14","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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"2026-05-14","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"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"33","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"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":"2026-05-14","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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"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":"2026-05-14","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"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"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":"2026-05-14","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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","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"],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":3555.25,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":10.73,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","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":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-14","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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"40380","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"27060","date_of_service":"2026-05-14","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"],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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","cbsa":"10580","date_of_service":"2026-05-14","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","NU"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":4.29,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":710.8,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"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":"2026-05-14","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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"40380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"21300","date_of_service":"2026-05-14","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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":74.95,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"28880","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":35.91,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"10580","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","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"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":6.64,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":3401.07,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":16.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":4037.47,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","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"]}],"provider_references":[1]}]},{"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":"2026-05-14","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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":18.47,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"28880","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"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":"2026-05-14","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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"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":"2026-05-14","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":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"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":"2026-05-14","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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-14","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":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"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":"2026-05-14","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","NU","KU"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","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"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":63.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":872.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"35004","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-14","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"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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.)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":["RR","KU"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":69.56,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":424.96,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","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"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"35614","date_of_service":"2026-05-14","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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"40380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"45060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"10580","date_of_service":"2026-05-14","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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[13]},{"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":["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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":89.54,"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":"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":"2026-05-14","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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","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":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","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"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","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":["RR","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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"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":"2026-05-14","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","NU","KU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":1.76,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","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":["RR"]}],"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":["RR"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":1958.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"46540","date_of_service":"2026-05-14","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":["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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"46540","date_of_service":"2026-05-14","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"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":21.27,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"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":"2026-05-14","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":["RR","KU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":12.24,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"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":"2026-05-14","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":[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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","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","KU"]}],"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":"2026-05-14","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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":11.73,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"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":"2026-05-14","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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":938.43,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","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"],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"27060","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":15.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["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","cbsa":"33","date_of_service":"2026-05-14","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"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":718.31,"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","cbsa":"35614","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"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":"2026-05-14","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":44.41,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"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":"2026-05-14","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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":181.63,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","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"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"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":"2026-05-14","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":[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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":565.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":1015.46,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":2060.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":368.79,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","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":["KL","NU"]}],"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"21300","date_of_service":"2026-05-14","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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":31.79,"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"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":"2026-05-14","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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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","cbsa":"10580","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"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":"2026-05-14","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"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-14","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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":2.48,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":1.97,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":10.18,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":2.13,"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-14","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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"35614","date_of_service":"2026-05-14","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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","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"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"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":"2026-05-14","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"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"24020","date_of_service":"2026-05-14","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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-14","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"]}],"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"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":30.52,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"13780","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"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":"2026-05-14","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":[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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-14","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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","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":["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","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","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"]}],"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":"28740","date_of_service":"2026-05-14","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":["UE","NU","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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":0.44,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":443.52,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-14","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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"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":"2026-05-14","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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","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"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"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":"2026-05-14","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":[3]},{"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]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-14","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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":3.76,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"45060","date_of_service":"2026-05-14","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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"]}],"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"]}],"provider_references":[13]}]},{"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":"2026-05-14","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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"35004","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":50.04,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":10.74,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":1.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-14","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":["KL"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":7153.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"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":"2026-05-14","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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","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"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":["UE","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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","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"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"45060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"35004","date_of_service":"2026-05-14","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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":73.23,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-14","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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":31.7,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","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":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":24.49,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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":["UE","KE","NU","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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":379.66,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"15380","date_of_service":"2026-05-14","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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-14","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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-14","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":["KL"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","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"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"40380","date_of_service":"2026-05-14","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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"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":"2026-05-14","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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":20.29,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","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":["UE","NU","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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":15.53,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":444.33,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":430.26,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","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"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","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"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","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","KU"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","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":["NU"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","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":["RR","KU"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"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":"2026-05-14","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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","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"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"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":"2026-05-14","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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"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":"2026-05-14","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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"10580","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-14","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"]}],"provider_references":[12]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","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","NU","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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":309.77,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","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"]}],"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"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"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":"2026-05-14","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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-14","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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"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":"2026-05-14","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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","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":[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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"35004","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":489.12,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","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","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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"28740","date_of_service":"2026-05-14","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":["RR"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","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"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","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":["RR","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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"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":"2026-05-14","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"],"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":"2026-05-14","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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"40380","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":4.53,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":1536.21,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":47.0,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"35004","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"40380","date_of_service":"2026-05-14","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":["UE","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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":54.09,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"21300","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"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":"2026-05-14","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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":2.25,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"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":"2026-05-14","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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":10.53,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":14.75,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":59.52,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","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"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"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":"2026-05-14","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"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":52.49,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","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"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","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":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"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":"2026-05-14","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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-14","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"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"27060","date_of_service":"2026-05-14","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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"21300","date_of_service":"2026-05-14","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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"46540","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-14","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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"15380","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"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":"2026-05-14","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"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"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":"2026-05-14","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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":1.74,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"13780","date_of_service":"2026-05-14","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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":144.64,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"46540","date_of_service":"2026-05-14","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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"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":"2026-05-14","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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":190.89,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","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","NU","KU"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":6.06,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","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":"2026-05-14","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":["UE","KE","NU","KU"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"13780","date_of_service":"2026-05-14","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"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"27060","date_of_service":"2026-05-14","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"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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.","cbsa":"27060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-14","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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-14","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"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"35004","date_of_service":"2026-05-14","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":["RR"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":15.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-14","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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":1903.17,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"10580","date_of_service":"2026-05-14","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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","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","NU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-14","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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["UE","NU"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-14","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"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":1180.48,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-14","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"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-14","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"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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":["NU"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"33","date_of_service":"2026-05-14","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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":17.78,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"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":"2026-05-14","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":["KL","NU"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-14","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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","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"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"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":"2026-05-14","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"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-14","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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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,","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"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":"2026-05-14","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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"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":"2026-05-14","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"],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"24020","date_of_service":"2026-05-14","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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","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"],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-14","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"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-14","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":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"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":"2026-05-14","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"],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","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":["KL"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":577.52,"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":"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":"2026-05-14","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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"28880","date_of_service":"2026-05-14","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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"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":"2026-05-14","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"],"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":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":9.79,"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":"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":"2026-05-14","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"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"33","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"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":"2026-05-14","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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":316.99,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"28880","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":4.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"15380","date_of_service":"2026-05-14","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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"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":"2026-05-14","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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"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":"2026-05-14","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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","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":["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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"27060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","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":["RR"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":4443.29,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","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":["NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","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","NU","KU"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"45060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"27060","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","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"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":55.58,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","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":["UE","KE","NU","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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"A4565","name":"Slings","description":"Slings","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":555.71,"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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"48060","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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"],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","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"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","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":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","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":["NU"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-14","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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":380.76,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":78.22,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"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":"2026-05-14","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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-14","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":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","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","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":["RR","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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"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":"2026-05-14","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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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","date_of_service":"2026-05-14","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"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":104.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-14","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":["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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":13.77,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":533.73,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":9.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-14","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":["KL"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-14","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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"27060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"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)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":82.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"35614","date_of_service":"2026-05-14","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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"46540","date_of_service":"2026-05-14","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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","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"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"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":"2026-05-14","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":[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":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":1.77,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":127.35,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"A4565","name":"Slings","description":"Slings","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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.)","date_of_service":"2026-05-14","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"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"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":"2026-05-14","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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"28740","date_of_service":"2026-05-14","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"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"21300","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["RR"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"28740","date_of_service":"2026-05-14","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"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"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":"2026-05-14","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"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"13780","date_of_service":"2026-05-14","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"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"35614","date_of_service":"2026-05-14","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","KU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"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":"2026-05-14","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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-14","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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":9593.28,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"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":"2026-05-14","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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"24020","date_of_service":"2026-05-14","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":["RR"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"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":"2026-05-14","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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"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":"2026-05-14","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":["KL","NU"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"27060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"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":"2026-05-14","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":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","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":["RR","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)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"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":"2026-05-14","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"],"billing_code_modifier":["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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","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":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"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":"2026-05-14","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":["KL","NU"]}],"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"27060","date_of_service":"2026-05-14","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":["UE","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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":107.22,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"24020","date_of_service":"2026-05-14","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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","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"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"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":"2026-05-14","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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":381.47,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"24020","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":245.79,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":1.79,"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":"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":"2026-05-14","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"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"28880","date_of_service":"2026-05-14","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"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"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":"2026-05-14","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"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":4.93,"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":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":37.54,"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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"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":"2026-05-14","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"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"40380","date_of_service":"2026-05-14","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"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"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":"2026-05-14","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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"48060","date_of_service":"2026-05-14","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":["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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":9.32,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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","KE","NU","KU"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":142.81,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"35614","date_of_service":"2026-05-14","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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"13780","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":1.97,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":2.37,"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":"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":"2026-05-14","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":["RR"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-14","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":[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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"33","date_of_service":"2026-05-14","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"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":312.49,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"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":"2026-05-14","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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"35004","date_of_service":"2026-05-14","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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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.","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":719.29,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","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","NU","KU"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":79.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":3.74,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":6.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","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":[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":"27060","date_of_service":"2026-05-14","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":["RR"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"35614","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"45060","date_of_service":"2026-05-14","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"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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"],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":32.21,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","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":["RR"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":36.88,"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":"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":"2026-05-14","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":[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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["RR"]}],"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":["RR"]}],"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)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"40380","date_of_service":"2026-05-14","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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-14","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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"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":"2026-05-14","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":["KL","NU"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-14","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":["KL"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"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":"2026-05-14","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"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","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":[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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","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":[13]},{"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"46540","date_of_service":"2026-05-14","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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":39.7,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"21300","date_of_service":"2026-05-14","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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":10154.6,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-14","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":[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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"15380","date_of_service":"2026-05-14","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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"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":"2026-05-14","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"],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"35004","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"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":"2026-05-14","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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","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"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","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","NU"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":536.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"15380","date_of_service":"2026-05-14","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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-14","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","KE","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","KE","NU","KU"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","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"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":749.49,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"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":"2026-05-14","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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":21.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-14","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"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"46540","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"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":"2026-05-14","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"],"billing_code_modifier":["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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":4.99,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":5251.6,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-14","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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-14","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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"46540","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"33","date_of_service":"2026-05-14","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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":260.24,"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":"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":"2026-05-14","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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":49.6,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"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":"2026-05-14","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":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","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"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":["RR"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","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":["RR"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"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":"2026-05-14","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":"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":"2026-05-14","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"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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","date_of_service":"2026-05-14","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"],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"45060","date_of_service":"2026-05-14","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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"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":"2026-05-14","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":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":633.2,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":584.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"13780","date_of_service":"2026-05-14","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":["RR"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","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":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"21300","date_of_service":"2026-05-14","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"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":496.0,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-14","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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","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":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":734.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":3.64,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-14","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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"45060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":90.46,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","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"],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-14","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"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":38.3,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":["RR"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-14","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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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.","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":48.77,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"15380","date_of_service":"2026-05-14","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":["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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"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":"2026-05-14","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":["RR","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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"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":"2026-05-14","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":"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":"2026-05-14","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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":614.8,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"21300","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":49.81,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"15380","date_of_service":"2026-05-14","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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-14","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"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"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":"2026-05-14","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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","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"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-14","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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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":["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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":1.63,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"28740","date_of_service":"2026-05-14","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"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":329.66,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":3.57,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-14","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":[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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"40380","date_of_service":"2026-05-14","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"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"35614","date_of_service":"2026-05-14","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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":782.15,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","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","KU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":7.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"46540","date_of_service":"2026-05-14","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","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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"33","date_of_service":"2026-05-14","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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-14","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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-14","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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":114.67,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":1.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"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":"2026-05-14","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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"35614","date_of_service":"2026-05-14","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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"35004","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"40380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"21300","date_of_service":"2026-05-14","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"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-14","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":["NU"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["RR"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":83.83,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["RR","KU"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","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":["RR"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"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":"2026-05-14","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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":15.88,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":5.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":46.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"35004","date_of_service":"2026-05-14","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"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":9.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":4097.97,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":2.12,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"13780","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"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":"2026-05-14","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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"24020","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":37.38,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"2026-05-14","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"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["KE","RR","KU"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"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":"2026-05-14","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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","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":"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":"2026-05-14","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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["RR"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":21.57,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":20.44,"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":"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":"2026-05-14","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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"33","date_of_service":"2026-05-14","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","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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"33","date_of_service":"2026-05-14","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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":70.08,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":382.68,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","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"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"40380","date_of_service":"2026-05-14","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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"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":"2026-05-14","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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"2026-05-14","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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-14","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"]}],"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"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"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":"2026-05-14","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"]}],"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)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"46540","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-14","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"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"48060","date_of_service":"2026-05-14","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"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-14","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":[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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"13780","date_of_service":"2026-05-14","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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"35004","date_of_service":"2026-05-14","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":["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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"15380","date_of_service":"2026-05-14","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":["KL"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"28740","date_of_service":"2026-05-14","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":["RR"]}],"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":"15380","date_of_service":"2026-05-14","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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"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":"2026-05-14","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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"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":"2026-05-14","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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-14","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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","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":["UE","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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"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":"2026-05-14","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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"28880","date_of_service":"2026-05-14","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":["KL"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":29.36,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":573.83,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4565","name":"Slings","description":"Slings","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","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"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":57.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":22.16,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":1.52,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-14","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":["KL"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-14","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"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"28880","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":1.78,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"13780","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":1.14,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":3118.68,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"33","date_of_service":"2026-05-14","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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":4249.57,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"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":"2026-05-14","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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"24020","date_of_service":"2026-05-14","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"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-14","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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":1015.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"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":"2026-05-14","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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":83.06,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"A4565","name":"Slings","description":"Slings","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"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":"2026-05-14","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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"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":"2026-05-14","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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","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"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-14","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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"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":"2026-05-14","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","NU","KU"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"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":"2026-05-14","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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","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"],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"46540","date_of_service":"2026-05-14","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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"13780","date_of_service":"2026-05-14","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"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"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":"2026-05-14","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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"10580","date_of_service":"2026-05-14","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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","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"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"15380","date_of_service":"2026-05-14","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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","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":["KE","RR","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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-14","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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"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":"2026-05-14","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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"45060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"28740","date_of_service":"2026-05-14","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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","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"],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"33","date_of_service":"2026-05-14","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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"40380","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-14","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":["NU"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":441.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","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","NU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-14","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"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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","NU"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"21300","date_of_service":"2026-05-14","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","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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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":["NU"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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","date_of_service":"2026-05-14","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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"45060","date_of_service":"2026-05-14","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":["KL"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":501.16,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"28740","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","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)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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":["NU"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":598.35,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"48060","date_of_service":"2026-05-14","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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"27060","date_of_service":"2026-05-14","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":["RR"]}],"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":"13780","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-14","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"],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"35614","date_of_service":"2026-05-14","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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"13780","date_of_service":"2026-05-14","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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":2.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","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"]}],"provider_references":[19]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"28880","date_of_service":"2026-05-14","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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":973.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":22.33,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-14","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":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":30.98,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"15380","date_of_service":"2026-05-14","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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","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"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":4891.13,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":3.93,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"46540","date_of_service":"2026-05-14","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"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"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":"2026-05-14","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"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"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":"2026-05-14","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":436.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-14","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":[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","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-14","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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"35004","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":492.38,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":191.9,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-14","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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","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"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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,","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"13780","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"45060","date_of_service":"2026-05-14","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","KU"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-14","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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"10580","date_of_service":"2026-05-14","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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":6.19,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","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"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","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"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"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":"2026-05-14","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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":0.3,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"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":"2026-05-14","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","NU","KU"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-14","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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":325.55,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"28740","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"33","date_of_service":"2026-05-14","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":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-14","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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"40380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","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","KU"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":1225.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","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"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":311.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","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":["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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"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":"2026-05-14","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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"28740","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":175.06,"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":"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":"2026-05-14","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"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","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":["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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":2.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"13780","date_of_service":"2026-05-14","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"],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"28880","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":153.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","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","NU"]}],"provider_references":[22]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"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":"2026-05-14","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":[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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":343.34,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":66.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-14","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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-14","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":["NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":454.5,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":151.24,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"24020","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":7107.98,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":57.76,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"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":"2026-05-14","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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"35004","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"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":"2026-05-14","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"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":1208.41,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"24020","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":100.11,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"28740","date_of_service":"2026-05-14","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"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"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":"2026-05-14","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","NU","KU"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":359.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"48060","date_of_service":"2026-05-14","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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-14","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"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":16.2,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","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":["UE","NU","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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"15380","date_of_service":"2026-05-14","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":["UE","NU","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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","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":"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":"2026-05-14","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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"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":"2026-05-14","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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"35614","date_of_service":"2026-05-14","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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-14","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"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"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":"2026-05-14","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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-14","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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-14","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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","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":["KL"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-14","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"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"40380","date_of_service":"2026-05-14","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":["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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":710.8,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":118.87,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"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":"2026-05-14","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":[13]},{"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":105.28,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"28880","date_of_service":"2026-05-14","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"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"27060","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":44.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":122.57,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":14.94,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":507.66,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","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":["KL","NU"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":340.11,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"40380","date_of_service":"2026-05-14","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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"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":"2026-05-14","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":["KL","NU"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","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":"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":"2026-05-14","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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"10580","date_of_service":"2026-05-14","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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":14.24,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","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":["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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":37.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":7107.98,"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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":6331.99,"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":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"35004","date_of_service":"2026-05-14","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"],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[5]}]},{"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":"2026-05-14","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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"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":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"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":"2026-05-14","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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-14","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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"40380","date_of_service":"2026-05-14","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","KU"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","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":["NU"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"28740","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"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":"2026-05-14","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":["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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":50.76,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"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":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","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":["KE","RR","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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"28880","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","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":["RR"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":84.42,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-14","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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"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":"2026-05-14","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"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","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":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-14","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"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":15.32,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"13780","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":90.01,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","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"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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":["NU"]}],"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)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"28740","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-14","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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-14","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"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"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":"2026-05-14","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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","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"],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":375.42,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","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"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"45060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"35004","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":49.2,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","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"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"33","date_of_service":"2026-05-14","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"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"27060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"27060","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"15380","date_of_service":"2026-05-14","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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"13780","date_of_service":"2026-05-14","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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"35004","date_of_service":"2026-05-14","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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":20.35,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":81.9,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A4619","name":"Face tent","description":"Face tent","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"45060","date_of_service":"2026-05-14","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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"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":"2026-05-14","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"],"billing_code_modifier":["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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"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":"2026-05-14","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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"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":"2026-05-14","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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["RR"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":38.52,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"40380","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","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":["RR"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":40.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":2436.52,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"15380","date_of_service":"2026-05-14","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":["RR"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-14","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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":150.46,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":11.61,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"10580","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","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"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":24.99,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"15380","date_of_service":"2026-05-14","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"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"21300","date_of_service":"2026-05-14","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":["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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","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"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":97.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"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":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-14","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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"33","date_of_service":"2026-05-14","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":["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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"28880","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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","cbsa":"35004","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","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":["KE","RR","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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":524.84,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-14","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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"45060","date_of_service":"2026-05-14","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"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"48060","date_of_service":"2026-05-14","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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"28880","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[3]},{"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":["RR"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"35004","date_of_service":"2026-05-14","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"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"46540","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":5952.64,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"46540","date_of_service":"2026-05-14","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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","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":["NU"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"24020","date_of_service":"2026-05-14","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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":6.99,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","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"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-14","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":[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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"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":"2026-05-14","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"10580","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-14","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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-14","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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"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":"2026-05-14","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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"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":"2026-05-14","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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","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"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":17.21,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35004","date_of_service":"2026-05-14","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","NU"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":261.95,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","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":["RR"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","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"],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"35614","date_of_service":"2026-05-14","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":["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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":8.39,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","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":"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":"2026-05-14","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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"45060","date_of_service":"2026-05-14","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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":61.05,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"33","date_of_service":"2026-05-14","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":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":18.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"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":"2026-05-14","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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","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":["KE","RR","KU"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"28880","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-14","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":["NU"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","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"],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-14","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"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","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":"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":"2026-05-14","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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"13780","date_of_service":"2026-05-14","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"],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"33","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"48060","date_of_service":"2026-05-14","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","KU"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"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":"2026-05-14","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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","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"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-14","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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":13.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","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":["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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"28880","date_of_service":"2026-05-14","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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"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":"2026-05-14","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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-14","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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"10580","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"28880","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["UE","NU","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)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":61.48,"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":"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":"2026-05-14","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"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"24020","date_of_service":"2026-05-14","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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"28740","date_of_service":"2026-05-14","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"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"40380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"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":"2026-05-14","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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"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":"2026-05-14","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"],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"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":"2026-05-14","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":["RR"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"46540","date_of_service":"2026-05-14","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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-14","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"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-14","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":["KL"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","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","KU"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"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":"2026-05-14","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"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":"2026-05-14","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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-14","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"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","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"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","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"],"billing_code_modifier":["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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-14","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"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"28880","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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":["NU"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"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":"2026-05-14","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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"35614","date_of_service":"2026-05-14","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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"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":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":334.08,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":13.45,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":5738.21,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":496.69,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","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":["RR"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","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"],"billing_code_modifier":["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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"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":"2026-05-14","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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":96.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":5.25,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"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":"2026-05-14","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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":219.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":355.15,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-14","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"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-14","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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","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","NU"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"13780","date_of_service":"2026-05-14","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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-14","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":[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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":385.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["UE","NU"]}],"provider_references":[13]},{"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":["UE","NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","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":["UE","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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":51.7,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"10580","date_of_service":"2026-05-14","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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"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":"2026-05-14","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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":1001.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","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"]}],"provider_references":[25]}]},{"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":"2026-05-14","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":["UE","NU"]}],"provider_references":[17]}]},{"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":"2026-05-14","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"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":33.27,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":108.41,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"10580","date_of_service":"2026-05-14","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"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-14","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":"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":"2026-05-14","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"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"15380","date_of_service":"2026-05-14","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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"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":"2026-05-14","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","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","NU","KU"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":447.76,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"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":["UE","NU","KU"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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.)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":101.0,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":77.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-14","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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":3807.53,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":29.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"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":"2026-05-14","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"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"33","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"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":"2026-05-14","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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"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":"2026-05-14","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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","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","NU"]}],"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":6.32,"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":"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":"2026-05-14","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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"33","date_of_service":"2026-05-14","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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","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":["RR","KU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"27060","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":4.01,"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":2674.15,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"10580","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"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":"2026-05-14","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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"24020","date_of_service":"2026-05-14","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":["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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":6.14,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","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":["RR"]}],"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":["RR"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"28740","date_of_service":"2026-05-14","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"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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.)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":11.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-14","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":[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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-14","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"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"10580","date_of_service":"2026-05-14","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":["KL"]}],"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)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":25.47,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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.)","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":38.64,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","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"]}],"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":"35614","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":458.89,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":77.36,"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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-14","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"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":9734.99,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"35614","date_of_service":"2026-05-14","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":["KL"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","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","NU"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"48060","date_of_service":"2026-05-14","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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"21300","date_of_service":"2026-05-14","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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":6.96,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","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"]}],"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"]}],"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":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"28880","date_of_service":"2026-05-14","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"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":291.7,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","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":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"35614","date_of_service":"2026-05-14","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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"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":"2026-05-14","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":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"15380","date_of_service":"2026-05-14","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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":37.01,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"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":"2026-05-14","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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"21300","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"10580","date_of_service":"2026-05-14","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","KU"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"35614","date_of_service":"2026-05-14","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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":222.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":18.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[13]},{"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":["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)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"33","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":32.56,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"35614","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","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"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"A4565","name":"Slings","description":"Slings","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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":["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":"2026-05-14","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"],"billing_code_modifier":["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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":45.51,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":403.75,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":17.5,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"48060","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":1.9,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"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":"2026-05-14","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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":4.84,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["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":"10580","date_of_service":"2026-05-14","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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"40380","date_of_service":"2026-05-14","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"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","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":["RR"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"13780","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"35004","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-14","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":[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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-14","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"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":5.97,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"27060","date_of_service":"2026-05-14","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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-14","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"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"28740","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":0.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"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":"2026-05-14","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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"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":"2026-05-14","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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"13780","date_of_service":"2026-05-14","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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"48060","date_of_service":"2026-05-14","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"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-14","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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"27060","date_of_service":"2026-05-14","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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-14","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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"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":"2026-05-14","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":"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":"2026-05-14","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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":71.59,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":71.61,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":238.55,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":56.01,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["RR"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":108.56,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"10580","date_of_service":"2026-05-14","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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":138.01,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","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"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","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"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"27060","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"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":"2026-05-14","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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":1.19,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","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"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"35004","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":11.91,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-14","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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":818.97,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","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"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":8.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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"],"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","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":["KL","NU"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"15380","date_of_service":"2026-05-14","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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-14","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"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":539.91,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":[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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","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"],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"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":"2026-05-14","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"],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":1.46,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"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":"2026-05-14","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"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":29.04,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":22.23,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"13780","date_of_service":"2026-05-14","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":["KL"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"28880","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","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":"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":"2026-05-14","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":["RR"]}],"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"13780","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":181.14,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":116.02,"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":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":3340.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-14","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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"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":"2026-05-14","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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","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","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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-14","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"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-14","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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[3]},{"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":["RR"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","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":[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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"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":"2026-05-14","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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":2.36,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","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"],"billing_code_modifier":["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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":160.03,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","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":["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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":2.61,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"35004","date_of_service":"2026-05-14","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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"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":"2026-05-14","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","KU"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":19.45,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":122.68,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":4.28,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":25.76,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"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":"2026-05-14","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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":56.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"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":"2026-05-14","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"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":[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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":454.56,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","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","NU"]}],"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)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"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":"2026-05-14","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"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"33","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":216.7,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"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":"2026-05-14","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"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","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"]}],"provider_references":[27]}]},{"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":"2026-05-14","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":"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":"2026-05-14","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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":81.16,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":1.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[23]}]},{"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":"2026-05-14","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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"13780","date_of_service":"2026-05-14","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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"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":"2026-05-14","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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"21300","date_of_service":"2026-05-14","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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"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":"2026-05-14","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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":738.31,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"35004","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":3839.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"28740","date_of_service":"2026-05-14","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":["RR"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"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":"2026-05-14","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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["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","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","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"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"40380","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"28740","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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 ","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":10.91,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","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"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"15380","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":410.86,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"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":"2026-05-14","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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-14","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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":4.69,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"33","date_of_service":"2026-05-14","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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"24020","date_of_service":"2026-05-14","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":["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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"45060","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":78.33,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"13780","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":41.09,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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","cbsa":"13780","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":4.93,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"21300","date_of_service":"2026-05-14","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":["KL"]}],"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)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":184.62,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":1.69,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","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":["KL"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"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":"2026-05-14","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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":5843.86,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"21300","date_of_service":"2026-05-14","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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"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":"2026-05-14","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","NU","KU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":2385.67,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","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"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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":["NU"]}],"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":"2026-05-14","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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"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":"2026-05-14","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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-14","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"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-14","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":["KL"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"45060","date_of_service":"2026-05-14","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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"28740","date_of_service":"2026-05-14","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"],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","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","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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"28880","date_of_service":"2026-05-14","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","KU"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"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":"2026-05-14","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"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":12.2,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":5337.24,"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":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":109.03,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"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":"2026-05-14","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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-14","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"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"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":"2026-05-14","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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-14","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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-14","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":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-14","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"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","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":"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":"2026-05-14","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"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","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","cbsa":"45060","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":538.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","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":["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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"A4619","name":"Face tent","description":"Face tent","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"45060","date_of_service":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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"],"billing_code_modifier":["RR"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":3.28,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"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":"2026-05-14","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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":34.34,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"21300","date_of_service":"2026-05-14","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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":406.4,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"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":"2026-05-14","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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-14","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"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":1.72,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":5.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":2.22,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"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":"2026-05-14","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","NU","KU"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":42.72,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"28880","date_of_service":"2026-05-14","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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":383.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"28740","date_of_service":"2026-05-14","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":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"27060","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":5.61,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"45060","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"10580","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":18.94,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4619","name":"Face tent","description":"Face tent","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":["KL","NU"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"35614","date_of_service":"2026-05-14","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-14","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":["NU"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"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":"2026-05-14","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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"33","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","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"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","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"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"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":"2026-05-14","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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":191.9,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"35614","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":229.92,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"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":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","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":[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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"24020","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"13780","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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","KU"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-14","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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":2166.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":137.64,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":1188.66,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"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":"2026-05-14","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"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"40380","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":38.38,"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","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"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":246.66,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"35004","date_of_service":"2026-05-14","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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":29.69,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":3124.83,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"40380","date_of_service":"2026-05-14","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":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":121.95,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":4.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"35004","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"15380","date_of_service":"2026-05-14","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","NU"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":7.74,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-14","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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"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":"2026-05-14","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"],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"35614","date_of_service":"2026-05-14","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","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","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","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"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":1612.72,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"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":"2026-05-14","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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-14","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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":489.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-14","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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","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"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","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":["KE","RR","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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":0.39,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"24020","date_of_service":"2026-05-14","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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-14","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":[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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["RR"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"10580","date_of_service":"2026-05-14","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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"13780","date_of_service":"2026-05-14","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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":38.87,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"10580","date_of_service":"2026-05-14","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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"35004","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":247.62,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"35004","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"13780","date_of_service":"2026-05-14","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":["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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"10580","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-14","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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"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":"2026-05-14","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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"A4619","name":"Face tent","description":"Face tent","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-14","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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"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":"2026-05-14","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","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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-14","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"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","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":["KL","NU"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"15380","date_of_service":"2026-05-14","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"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","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"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":49.48,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-14","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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","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"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":59.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","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":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","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"]}],"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"]}],"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","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":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"45060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-14","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"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":491.45,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"15380","date_of_service":"2026-05-14","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"],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"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":"2026-05-14","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"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":4.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","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","NU","KU"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","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":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":959.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","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":["UE","NU","KU"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","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"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"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":"2026-05-14","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"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":"2026-05-14","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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"35614","date_of_service":"2026-05-14","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":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","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":["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":"2026-05-14","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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":0.17,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"35614","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[6]}]},{"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":"2026-05-14","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":"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":"2026-05-14","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":"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":"2026-05-14","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":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-14","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"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","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":["KE","RR","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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"35614","date_of_service":"2026-05-14","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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"21300","date_of_service":"2026-05-14","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":["RR"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"13780","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"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":"2026-05-14","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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","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"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","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":["RR","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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"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":"2026-05-14","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"],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":191.9,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":2385.46,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":21.92,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"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":"2026-05-14","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":[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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":122.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":29.68,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"A4619","name":"Face tent","description":"Face tent","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"13780","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","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"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"35614","date_of_service":"2026-05-14","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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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"],"billing_code_modifier":["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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":45.45,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":38.59,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","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":["UE","NU","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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"28880","date_of_service":"2026-05-14","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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":3.33,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":277.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":74.74,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":697.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":7348.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"27060","date_of_service":"2026-05-14","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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"28880","date_of_service":"2026-05-14","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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":15.19,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"48060","date_of_service":"2026-05-14","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"13780","date_of_service":"2026-05-14","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"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","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"],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"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":"2026-05-14","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"],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"28740","date_of_service":"2026-05-14","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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":3.21,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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"],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":38.35,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"27060","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[3]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["KE","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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":16.77,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"13780","date_of_service":"2026-05-14","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"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":238.57,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":7.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","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":["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":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"10580","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"28880","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":93.15,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"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":"2026-05-14","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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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","NU"]}],"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"35004","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"10580","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"28740","date_of_service":"2026-05-14","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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":494.74,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["RR","KU"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":68.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-14","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"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":919.62,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":4.07,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","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":[2]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["RR"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-14","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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-14","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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"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":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-14","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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"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":"2026-05-14","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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","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"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-14","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"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":38.27,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-14","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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"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":"2026-05-14","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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-14","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-14","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"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"46540","date_of_service":"2026-05-14","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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"24020","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":4588.94,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"10580","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"48060","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":175.92,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"21300","date_of_service":"2026-05-14","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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":69.83,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":23.44,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":2.98,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"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":"2026-05-14","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":["KL","NU"]}],"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":["KL","NU"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"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":"2026-05-14","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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":44.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":388.72,"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":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"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":"2026-05-14","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"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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":["UE","KE","NU","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":["UE","KE","NU","KU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":5.96,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"2026-05-14","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"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","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"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-14","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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"46540","date_of_service":"2026-05-14","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"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"A4565","name":"Slings","description":"Slings","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"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":"2026-05-14","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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"27060","date_of_service":"2026-05-14","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":["RR","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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":168.65,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"21300","date_of_service":"2026-05-14","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"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-14","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":["KL"]}],"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":["KL"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","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":["RR"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","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":["RR"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"40380","date_of_service":"2026-05-14","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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"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":"2026-05-14","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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":50.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","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","NU"]}],"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","NU"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"35004","date_of_service":"2026-05-14","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":["UE","NU","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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-14","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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-14","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":[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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","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","NU","KU"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"46540","date_of_service":"2026-05-14","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":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-14","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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"28740","date_of_service":"2026-05-14","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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":254.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"24020","date_of_service":"2026-05-14","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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","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":["RR"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"21300","date_of_service":"2026-05-14","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":["RR","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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"15380","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"10580","date_of_service":"2026-05-14","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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"27060","date_of_service":"2026-05-14","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"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"45060","date_of_service":"2026-05-14","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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"21300","date_of_service":"2026-05-14","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":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-14","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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"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":"2026-05-14","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"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","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"],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"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":"2026-05-14","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":["RR"]}],"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":"2026-05-14","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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"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":"2026-05-14","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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"28880","date_of_service":"2026-05-14","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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"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":"2026-05-14","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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":1.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-14","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"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"10580","date_of_service":"2026-05-14","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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"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":"2026-05-14","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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-14","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":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":1229.84,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":4375.62,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"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":"2026-05-14","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","NU","KU"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","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":["RR","KU"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"45060","date_of_service":"2026-05-14","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"10580","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"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":"2026-05-14","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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","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":["KE","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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-14","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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"28880","date_of_service":"2026-05-14","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":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":46.01,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[7]}]},{"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"28740","date_of_service":"2026-05-14","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","KU"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","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"],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":3352.67,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","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":["RR"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","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":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-14","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":[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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":93.13,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":24.17,"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":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"33","date_of_service":"2026-05-14","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"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"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":"2026-05-14","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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","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"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","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"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","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":["RR"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":16.75,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"10580","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"48060","date_of_service":"2026-05-14","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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":142.61,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"35614","date_of_service":"2026-05-14","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":["KL"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","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":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"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":"2026-05-14","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","NU","KU"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"35004","date_of_service":"2026-05-14","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","KU"]}],"provider_references":[24]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"A4619","name":"Face tent","description":"Face tent","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"27060","date_of_service":"2026-05-14","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","NU"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":24.86,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"28740","date_of_service":"2026-05-14","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":46.66,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"40380","date_of_service":"2026-05-14","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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"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":"2026-05-14","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"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":633.2,"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":"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":"2026-05-14","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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":19.67,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"46540","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"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":"2026-05-14","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"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":438.25,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":2.97,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"27060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":["UE","NU","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)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"13780","date_of_service":"2026-05-14","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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"negotiated","negotiated_rate":151.5,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":32.03,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-14","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"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"A4565","name":"Slings","description":"Slings","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","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":["KL","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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"24020","date_of_service":"2026-05-14","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":["UE","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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":74.44,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"27060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"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":"2026-05-14","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"]}],"provider_references":[11]}]},{"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":"2026-05-14","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"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"40380","date_of_service":"2026-05-14","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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":916.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-14","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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":134.84,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":811.59,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-14","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"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"13780","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-14","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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":60.54,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":2153.78,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"35004","date_of_service":"2026-05-14","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":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":4361.79,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","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":"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":"2026-05-14","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"]}],"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":"2026-05-14","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":["RR","KU"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"46540","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","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":["KE","RR","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":"2026-05-14","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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":3.78,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"45060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","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"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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","KE","NU","KU"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-14","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":1.79,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"27060","date_of_service":"2026-05-14","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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":595.27,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"27060","date_of_service":"2026-05-14","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"],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":[13]},{"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"40380","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"46540","date_of_service":"2026-05-14","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","NU"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":116.5,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"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":"2026-05-14","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":["KL","NU"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":215.38,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":744.4,"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":"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":"2026-05-14","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":["UE","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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"28880","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-14","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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"35614","date_of_service":"2026-05-14","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":["RR"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["RR"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"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":"2026-05-14","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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"27060","date_of_service":"2026-05-14","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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"10580","date_of_service":"2026-05-14","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"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":738.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-14","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":383.46,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"28740","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"percentage","negotiated_rate":20.0,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"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":"2026-05-14","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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"46540","date_of_service":"2026-05-14","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"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","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":["KL","NU"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"13780","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-14","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":[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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":11.32,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":2602.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"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":"2026-05-14","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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"10580","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"40380","date_of_service":"2026-05-14","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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":6.44,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":31.11,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","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"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-14","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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","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","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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"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":"2026-05-14","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":["KL","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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","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"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":830.53,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-14","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"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"28740","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-14","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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","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"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","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"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"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":"2026-05-14","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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"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":"2026-05-14","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"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"40380","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":161.91,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":4524.88,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"48060","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","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","KU"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-14","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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"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":"2026-05-14","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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","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":[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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":17.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["RR"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"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":"2026-05-14","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","NU","KU"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":6.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"15380","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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":["RR"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":22.93,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":11.65,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"28880","date_of_service":"2026-05-14","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"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.86,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-14","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"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"provider_references":[18]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":["RR"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"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":"2026-05-14","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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"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":"2026-05-14","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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-14","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"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"35614","date_of_service":"2026-05-14","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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-14","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"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":436.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"40380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.83,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"46540","date_of_service":"2026-05-14","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"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":9.61,"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":"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":"2026-05-14","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"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":10.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":28.32,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","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":["RR"]}],"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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","cbsa":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"35614","date_of_service":"2026-05-14","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":["RR"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":39.07,"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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"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":"2026-05-14","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"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":16.9,"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":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-14","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":[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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":158.78,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"33","date_of_service":"2026-05-14","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"],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"40380","date_of_service":"2026-05-14","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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-14","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"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","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":["KE","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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":6191.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.5,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"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":"2026-05-14","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"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","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","KE","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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":1567.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"15380","date_of_service":"2026-05-14","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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"40380","date_of_service":"2026-05-14","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"35004","date_of_service":"2026-05-14","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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":["KE","RR","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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"24020","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":11.47,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":1.88,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":5.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":1.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","NU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":7.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","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":["RR","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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"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":"2026-05-14","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":["KL","NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-14","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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","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":["RR"]}],"provider_references":[13]},{"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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"45060","date_of_service":"2026-05-14","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","NU"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","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","cbsa":"28740","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"10580","date_of_service":"2026-05-14","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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"35004","date_of_service":"2026-05-14","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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":26.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"24020","date_of_service":"2026-05-14","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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":16.44,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":8.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":3.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"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":"2026-05-14","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":"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":"2026-05-14","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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":2.98,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","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"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":["UE","NU"]}],"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)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-14","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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-14","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","KU"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-14","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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"40380","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.6,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"40380","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":59.84,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"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":"2026-05-14","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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":257.53,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"10580","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":1337.38,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":5.57,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-14","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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":2.16,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":619.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":81.02,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"45060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"10580","date_of_service":"2026-05-14","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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"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":"2026-05-14","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"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"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":"2026-05-14","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","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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":222.27,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":172.04,"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","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"],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-14","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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"2026-05-14","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":["RR","KU"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"15380","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":2.04,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-14","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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","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":["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)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"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":"2026-05-14","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"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-14","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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-14","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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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":"2026-05-14","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":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","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":["RR"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.56,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-14","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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"40380","date_of_service":"2026-05-14","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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-14","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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A4619","name":"Face tent","description":"Face tent","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-14","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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":56.51,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":179.69,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"10580","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"45060","date_of_service":"2026-05-14","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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"45060","date_of_service":"2026-05-14","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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":3.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":1.22,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["UE","NU"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","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":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"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":"2026-05-14","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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"28740","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","KE","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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":5131.51,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[15]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":37.59,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"27060","date_of_service":"2026-05-14","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":["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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"40380","date_of_service":"2026-05-14","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"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-14","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"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":4.14,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.84,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"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":"2026-05-14","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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":["RR","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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":469.97,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.18,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":5.41,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-14","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"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-14","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"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"28880","date_of_service":"2026-05-14","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":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"28880","date_of_service":"2026-05-14","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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-14","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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":55.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":10.47,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":7.16,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["UE","NU"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"15380","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-14","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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"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":"2026-05-14","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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":169.84,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":16.35,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"27060","date_of_service":"2026-05-14","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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A4619","name":"Face tent","description":"Face tent","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"27060","date_of_service":"2026-05-14","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","KU"]}],"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.)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"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":"2026-05-14","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"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4322.8,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-14","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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-14","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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"15380","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":290.79,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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"],"billing_code_modifier":["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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-14","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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"27060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-14","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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","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","NU"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-14","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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"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":"2026-05-14","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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":29.04,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"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":"2026-05-14","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":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":190.32,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":155.22,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","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":["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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":125.96,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"13780","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"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":"2026-05-14","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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-14","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":[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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":12.74,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"35004","date_of_service":"2026-05-14","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":["KL"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"21300","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"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":"2026-05-14","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":["RR"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"40380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"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":"2026-05-14","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"],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"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":"2026-05-14","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"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"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":"2026-05-14","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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"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":"2026-05-14","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"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-14","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"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","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":"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":"2026-05-14","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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"27060","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","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"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-14","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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":2.92,"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":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","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"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","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"],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"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":"2026-05-14","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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"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":"2026-05-14","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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":61.9,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"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":"2026-05-14","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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":0.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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","KU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":317.85,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"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":"2026-05-14","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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":23.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-14","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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"15380","date_of_service":"2026-05-14","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":["RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"28880","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"35614","date_of_service":"2026-05-14","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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-14","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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"15380","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"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":"2026-05-14","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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"28880","date_of_service":"2026-05-14","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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":344.46,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":430.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.34,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"46540","date_of_service":"2026-05-14","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":["RR"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"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":"2026-05-14","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":["RR"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","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"]}],"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":"46540","date_of_service":"2026-05-14","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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":3551.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-14","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"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"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":"2026-05-14","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":["RR","KU"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-14","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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":572.91,"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":"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":"2026-05-14","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":["KL","NU"]}],"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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"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":"2026-05-14","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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"15380","date_of_service":"2026-05-14","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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","cbsa":"33","date_of_service":"2026-05-14","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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-14","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"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-14","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":["NU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","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"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"40380","date_of_service":"2026-05-14","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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","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":["RR","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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","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"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.32,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","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"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"28880","date_of_service":"2026-05-14","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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","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":["RR"]}],"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)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"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":"2026-05-14","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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","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"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-14","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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5770.75,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2656.3,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"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":"2026-05-14","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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","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"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.69,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.59,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.01,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"28740","date_of_service":"2026-05-14","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"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":8.17,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"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":"2026-05-14","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"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"40380","date_of_service":"2026-05-14","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":["RR"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","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":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","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"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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","NU","KU"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-14","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"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":2.03,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"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":"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":"2026-05-14","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"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":16.99,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"48060","date_of_service":"2026-05-14","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":["KL"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"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":"2026-05-14","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"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-14","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":[13]},{"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","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":["KL","NU"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"45060","date_of_service":"2026-05-14","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"]}],"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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"35614","date_of_service":"2026-05-14","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":["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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-14","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":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[13]},{"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":["KE","RR","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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"40380","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-14","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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"24020","date_of_service":"2026-05-14","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"]}],"provider_references":[20]}]},{"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":"2026-05-14","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"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.93,"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"13780","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":[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","cbsa":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.2,"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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.46,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"33","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.27,"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"10580","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"2026-05-14","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"],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.27,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":7.27,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.35,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":1796.87,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.47,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.43,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.69,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-14","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"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"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":"2026-05-14","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"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":138.68,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.57,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"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":"2026-05-14","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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":157.08,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"27060","date_of_service":"2026-05-14","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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"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":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":399.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"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":"2026-05-14","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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-14","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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"35614","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"45060","date_of_service":"2026-05-14","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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"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":"2026-05-14","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"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-14","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":["KL"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"10580","date_of_service":"2026-05-14","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"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"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":"2026-05-14","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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":1.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-14","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"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.5,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"35004","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-14","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"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","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"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.05,"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":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"28740","date_of_service":"2026-05-14","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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.85,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":519.56,"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-14","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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":164.39,"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":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.04,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-14","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"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.2,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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"],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.81,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"21300","date_of_service":"2026-05-14","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","NU"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.32,"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":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.79,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"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":"2026-05-14","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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-14","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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","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"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"13780","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[14]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.27,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"48060","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2856.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.87,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","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"]}],"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)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.96,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":15.05,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"28880","date_of_service":"2026-05-14","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"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[15]}]},{"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-14","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","KE","NU","KU"]}],"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.85,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-14","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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.7,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-14","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"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.76,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.62,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":43.03,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"15380","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.56,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.05,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.15,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"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":"2026-05-14","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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.8,"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.8,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.33,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":386.32,"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.23,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","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":["KL","NU"]}],"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":"45060","date_of_service":"2026-05-14","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","NU","KU"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-14","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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":487.64,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.64,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"28880","date_of_service":"2026-05-14","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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"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":"2026-05-14","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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"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":"2026-05-14","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"],"billing_code_modifier":["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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.02,"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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.41,"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":471.7,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.11,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"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":"2026-05-14","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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":400.14,"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","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"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"28880","date_of_service":"2026-05-14","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"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-14","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":["UE","KE","NU","KU"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.76,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":0.57,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","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":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":137.33,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"35004","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.57,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"48060","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-14","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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"24020","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.49,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":4001.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"15380","date_of_service":"2026-05-14","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"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"28740","date_of_service":"2026-05-14","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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.74,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"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":"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":"2026-05-14","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":[13]},{"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.93,"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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"35614","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.18,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-14","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"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.33,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.61,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.73,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"46540","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.15,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.65,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"35004","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.15,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":4477.53,"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":"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":"2026-05-14","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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"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":"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":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.02,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"28740","date_of_service":"2026-05-14","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"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"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":"2026-05-14","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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","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"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":["UE","NU","KU"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"28880","date_of_service":"2026-05-14","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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3565.28,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2413.9,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"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":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-14","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":[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)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"15380","date_of_service":"2026-05-14","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"],"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.89,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":17.83,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"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":"2026-05-14","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":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.16,"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":513.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"48060","date_of_service":"2026-05-14","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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"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":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.29,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.5,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"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":"2026-05-14","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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.36,"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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.83,"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"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":"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":"2026-05-14","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":["KL","NU"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.55,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.26,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.08,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1616.8,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.44,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.31,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.28,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"35614","date_of_service":"2026-05-14","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":["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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"28740","date_of_service":"2026-05-14","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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-14","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"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"33","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"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":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-14","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":["KL"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["KE","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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":136.5,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.66,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":9.25,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.83,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.93,"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.3,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.49,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"46540","date_of_service":"2026-05-14","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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.25,"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.18,"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.4,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","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":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.49,"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-14","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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"40380","date_of_service":"2026-05-14","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":["RR"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"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":"35004","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"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":"2026-05-14","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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.26,"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":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"40380","date_of_service":"2026-05-14","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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-14","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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.55,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.17,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.23,"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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2898.82,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.32,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.05,"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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.8,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"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":"A4565","name":"Slings","description":"Slings","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","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"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"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":"2026-05-14","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"]}],"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"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"45060","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"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":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.02,"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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.43,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.9,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"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":"2026-05-14","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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4065.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":372.07,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-14","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":["RR"]}],"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":"2026-05-14","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"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.52,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.71,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.25,"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":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","RR","KU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.09,"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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.24,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"28740","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.69,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.85,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","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"],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["UE","KE","NU","KU"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.49,"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":43.03,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.39,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"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":"2026-05-14","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","NU","KU"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","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"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.93,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.98,"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":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.84,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.29,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":81.64,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":24.14,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"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":0.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.76,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"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":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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)","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-14","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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.52,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"45060","date_of_service":"2026-05-14","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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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","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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.03,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.47,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.41,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.32,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"21300","date_of_service":"2026-05-14","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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"28740","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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":"40380","date_of_service":"2026-05-14","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"],"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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.57,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"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":34.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.69,"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-14","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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.18,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"15380","date_of_service":"2026-05-14","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"],"billing_code_modifier":["NU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"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":"2026-05-14","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":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"35614","date_of_service":"2026-05-14","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"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":0.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"24020","date_of_service":"2026-05-14","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":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.7,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"48060","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5402.06,"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"45060","date_of_service":"2026-05-14","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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.78,"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"40380","date_of_service":"2026-05-14","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":["RR"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.75,"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","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"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.08,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.78,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.27,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"35614","date_of_service":"2026-05-14","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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.18,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.17,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"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":"2026-05-14","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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-14","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":["UE","NU","KU"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.12,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.32,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"40380","date_of_service":"2026-05-14","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"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"28880","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.29,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.93,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"24020","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"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":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3050.2,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"13780","date_of_service":"2026-05-14","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":"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":"2026-05-14","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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"45060","date_of_service":"2026-05-14","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"]}],"provider_references":[27]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.46,"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":13.74,"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.57,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.74,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"46540","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.08,"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"13780","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"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":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.1,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"40380","date_of_service":"2026-05-14","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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.55,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.78,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.55,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.64,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.81,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.57,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.26,"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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.)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.24,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.71,"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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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.)","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","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"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","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"],"billing_code_modifier":["UE","NU"]}],"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)","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.73,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"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":"2026-05-14","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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.88,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.36,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"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":92.47,"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.78,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":["KL","NU"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.11,"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2258.99,"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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.83,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.92,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.9,"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":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-14","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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"45060","date_of_service":"2026-05-14","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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"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":"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":"2026-05-14","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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.32,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"48060","date_of_service":"2026-05-14","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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.52,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.85,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":42.26,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.05,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.11,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.7,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.06,"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":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"35614","date_of_service":"2026-05-14","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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.76,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.75,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.5,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.09,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.48,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.91,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5817.79,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.8,"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.31,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"35614","date_of_service":"2026-05-14","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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.83,"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":"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":"2026-05-14","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":["RR"]}],"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.65,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.68,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.17,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.45,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.88,"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.05,"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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.63,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.44,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-14","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"],"billing_code_modifier":["KE","NU"]}],"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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"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":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.38,"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":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.81,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.12,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.55,"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":4.35,"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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.05,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.26,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.83,"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":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.9,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.77,"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[9]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.26,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.39,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.23,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.46,"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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"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":"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":"2026-05-14","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"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"45060","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.77,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.63,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":15.71,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.99,"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":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"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":25.68,"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.14,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.24,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.39,"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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":283.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"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":"10580","date_of_service":"2026-05-14","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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"27060","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.85,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"28740","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.43,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.37,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.89,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.85,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":["RR","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","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.73,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"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":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.54,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3207.77,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.35,"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":"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":"2026-05-14","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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"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":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.9,"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"48060","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":196.95,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.66,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.26,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.35,"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.89,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.21,"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":37.21,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.27,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.19,"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.64,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":153.95,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.34,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"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":305.16,"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.16,"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.73,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.45,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":34.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.89,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.1,"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":12084.1,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.69,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","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","KE","NU","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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.05,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-14","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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"21300","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"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":"2026-05-14","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":["UE","NU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"24020","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.15,"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":"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":"2026-05-14","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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.86,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.62,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.62,"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.19,"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"21300","date_of_service":"2026-05-14","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":["UE","NU"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.44,"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"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":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.45,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","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":["KE","RR","KU"]}],"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":["KE","RR","KU"]}],"provider_references":[13]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"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":8.11,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"28740","date_of_service":"2026-05-14","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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"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":"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":"2026-05-14","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":["UE","NU","KU"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-14","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":["RR"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"48060","date_of_service":"2026-05-14","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":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.13,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.73,"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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.5,"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"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":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-14","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"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.17,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.75,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"35004","date_of_service":"2026-05-14","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"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.98,"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"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":"2026-05-14","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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.24,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.06,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.15,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.83,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.51,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.37,"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2439.15,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5331.86,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"28880","date_of_service":"2026-05-14","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"]}],"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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2925.76,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"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":"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":"2026-05-14","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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"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":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":1.28,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.5,"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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.18,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.78,"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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","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":["UE","NU"]}],"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","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"33","date_of_service":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"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":2.84,"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.21,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.6,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.24,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.19,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.2,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.06,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2788.87,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-14","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":[3]},{"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]}]},{"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.1,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.87,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.71,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":4063.94,"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.47,"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"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":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.59,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.35,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.3,"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"46540","date_of_service":"2026-05-14","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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.35,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"35614","date_of_service":"2026-05-14","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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-14","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":["RR"]}],"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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.75,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.77,"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.33,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.18,"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.43,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3246.71,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"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":3.23,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2878.5,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.37,"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":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"35614","date_of_service":"2026-05-14","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":["UE","NU"]}],"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.85,"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.43,"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.39,"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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.86,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"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":285.3,"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.72,"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":640.72,"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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"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":"2026-05-14","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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.21,"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"10580","date_of_service":"2026-05-14","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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.74,"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-14","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":["RR"]}],"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":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3933.95,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.14,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_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":"21300","date_of_service":"2026-05-14","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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.45,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"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":"10580","date_of_service":"2026-05-14","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"]}],"provider_references":[16]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.41,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.67,"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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.86,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"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":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.5,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"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":"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":"2026-05-14","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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.2,"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.62,"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.19,"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":"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":"2026-05-14","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"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":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.35,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.21,"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.49,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.05,"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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1868.5,"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"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":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.62,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.45,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.88,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3227.74,"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.84,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"35004","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.34,"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6878.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.85,"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.02,"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.01,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.75,"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.56,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.46,"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","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":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.75,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.33,"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.3,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.75,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.17,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":20.0,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.6,"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":10154.6,"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.48,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"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":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.65,"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"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":"2026-05-14","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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.95,"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-14","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":[1]}]},{"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_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","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.07,"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.02,"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":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.53,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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.)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.9,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.25,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.28,"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":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.75,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.3,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"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":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"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":"2026-05-14","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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.44,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.5,"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":"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":"2026-05-14","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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.05,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.43,"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":"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":"2026-05-14","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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.28,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.89,"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.77,"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"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":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"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":8.21,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.39,"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2837.59,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"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":"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":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":721.11,"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"35614","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.02,"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.1,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.28,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.75,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.01,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.46,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.56,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.55,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"40380","date_of_service":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"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":"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":"2026-05-14","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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.84,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.25,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"45060","date_of_service":"2026-05-14","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"]}],"provider_references":[27]}]},{"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.15,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"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":"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":"2026-05-14","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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.1,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"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":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.1,"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":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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":"2026-05-14","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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"28880","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.33,"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.73,"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":"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":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.84,"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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","date_of_service":"2026-05-14","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.69,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","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":["KE","RR","KU"]}],"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","cbsa":"13780","date_of_service":"2026-05-14","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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.32,"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.75,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3166.35,"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.36,"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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.05,"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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.51,"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"33","date_of_service":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.58,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.38,"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":"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":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.28,"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":"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":"2026-05-14","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"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":"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":"2026-05-14","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.05,"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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.19,"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"28880","date_of_service":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.13,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"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":"2026-05-14","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"]}],"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.68,"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"35614","date_of_service":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"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":"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":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.57,"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":"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":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.31,"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":"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":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"28740","date_of_service":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.48,"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":"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":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"21300","date_of_service":"2026-05-14","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.9,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"24020","date_of_service":"2026-05-14","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"15380","date_of_service":"2026-05-14","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.18,"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":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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","cbsa":"48060","date_of_service":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"27060","date_of_service":"2026-05-14","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"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":"2026-05-14","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"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":"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":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-14","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"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","date_of_service":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"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":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[13]},{"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":["RR","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","cbsa":"45060","date_of_service":"2026-05-14","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-14","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.33,"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":"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":"2026-05-14","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-14","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"13780","date_of_service":"2026-05-14","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"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":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"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":"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":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.55,"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"13780","date_of_service":"2026-05-14","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":["RR","KU"]}],"provider_references":[17]}]},{"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"2026-05-14","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"10580","date_of_service":"2026-05-14","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"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":"2026-05-14","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-14","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.15,"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"35004","date_of_service":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.65,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"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":"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":"2026-05-14","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_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":"35614","date_of_service":"2026-05-14","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.91,"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":"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":"2026-05-14","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.65,"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":"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":"2026-05-14","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":2228.21,"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":"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":"2026-05-14","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"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":"2026-05-14","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.93,"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-14","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"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":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-14","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.79,"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":"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":"2026-05-14","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"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":"2026-05-14","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]}]}